When my psoriasis first became severe, I looked into the potential role that diet could play in exacerbating or alleviating my condition. In addition to following an anti-inflammatory diet and addressing food sensitivities, some people with psoriasis have reported success with the autoimmune protocol (or AIP) diet. This diet focuses on eliminating foods that may be causing inflammation. It calls for individuals to consume a limited set of low-risk foods to see if they notice an improvement in symptoms. From there, they begin adding back in foods while monitoring for a flare.
Long before I developed psoriasis, my diet consisted mainly of whole, unprocessed food. I consumed an abundance of fresh fruits and vegetables and had been a vegetarian for more than 15 years. I already considered myself a healthy eater. However, when psoriasis took over my body, I was willing to try anything to make it go away. Moreover, the idea that something I was eating was causing my psoriasis to flare was appealing to me because it suggested that I could make myself better through behavioral changes alone. Healing was in my control.
Eventually, I eliminated gluten, all grains, legumes, nuts, dairy, soy, corn, nightshade vegetables, alcohol, and sugar from my diet. I didn’t just cut out added sugar; I also ensured that even my fruit intake amounted to fewer than 40 grams of natural sugar a day. As a vegetarian, this didn’t leave me with a lot of food options, so I incorporated meat into my diet despite my ethical reservations and years of commitment to the vegetarian lifestyle. For months, I was only consuming bone broth, unseasoned salmon, coconut oil, lots of sweet potatoes, other vegetables excluding nightshades, and small quantities of fruit.
For obvious reasons, this strict elimination diet is not meant to be a long-term approach and should eventually lead to reintroduction. After shifting to this elimination diet, my psoriasis symptoms only worsened. I convinced myself that my body was finally purging the toxins that had to have been responsible for my psoriasis and I only needed to stick with the elimination diet a little longer to experience relief.
Soon, I was underweight and malnourished. My rational mind would have recognized that trading potential inflammation for nutrient deficiencies was the last thing that was going to help my psoriasis and would have seen that this elimination diet wasn’t working for me. But at this point, my eating-disordered mind had taken over. The food groups I had eliminated were now “fear foods” and the thought of consuming them triggered an onset of panic.
Thus, I found myself back in a familiar place. I had been hospitalized for anorexia in high school. Through treatment for anorexia as well as co-occurring obsessive-compulsive disorder, I had been in recovery for years until psoriasis retriggered my disordered eating. In my experience, disordered eating behaviors — restriction, in particular — can serve the function of masking certain feelings or quelling obsessive thought patterns. In high school, I thought food was contaminated and would make me ill. Now, I thought it could be causing my psoriasis.
When my psoriasis was at its worst, I was under immense stress. It makes sense that at this time, I resorted to old habits that gave me a sense of control amidst uncertainty and overwhelm. Unfortunately, it took me a long time to recognize my restriction of foods as disordered eating. I was able to respond to the concern of loved ones by telling them I was following a protocol for alleviating psoriasis — and I believed it, too!
By being honest with my therapist, I was eventually able to see my behavior as disordered eating and began working with her, as well as a nutritionist, to reintroduce foods. This has not been easy. Reintroducing foods is essentially exposure therapy: doing the scary thing and having it feel terrible but then realizing you’re OK and the thing becoming less scary. But my body is happier now, and I am enjoying many more foods. The anxiety remains that something I am consuming could be making my psoriasis worse, but I am choosing to accept non-closure with this and instead focusing on the life I want to lead — one that does not revolve around food fears.
MyPsoriasisTeam columnists discuss psoriasis from a specific point of view. Columnists' articles don’t reflect the opinions of MyPsoriasisTeam staff, medical experts, partners, advertisers, or sponsors. MyPsoriasisTeam content isn't intended as a substitute for professional medical advice, diagnosis, or treatment.